Individual
JONATHAN QUOC PHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
203 PHARMACY BLDG, CORVALLIS, OR 97331-8537
(541) 737-3424
Mailing address
203 PHARMACY BLDG, CORVALLIS, OR 97331-8537
(541) 737-3424
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
PI-0014377
OR
Other
Enumeration date
05/28/2024
Last updated
05/28/2024
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